Faster medical appointments for acute problems

With A and B referrals faster to the specialist

05/14/2014

In Mecklenburg-Vorpommern patients with urgent medical problems can get an appointment with the specialist within one working day. The model with A and B remittances had proven itself, it was said by the Association of Statutory Health Insurance Physicians and the AOK Northeast.

Specialist appointment within one working day
In Mecklenburg-Vorpommern, patients with an urgent medical problem are offered a quick appointment with a specialist. The Kassenärztliche Vereinigung and the AOK Nordost come to this conclusion after evaluating the model tested in Mecklenburg-Western Pomerania with A and B credit transfers. The treating physicians distinguish between three categories in this system. An A referral will be given to patients with high-grade illnesses; they are taken over by a specialist within one working day. Patients with less urgent health problems, but who, for example, have experienced a worsening of their health during ongoing therapy receive a B-referral and a specialist appointment within one week. And all other referrals, such as for routine check-ups, are not labeled and therefore not eligible for an appointment within these deadlines.

Effective and bureaucratic model
As it was said, the way in which the attending physician carries out the medical evaluation in advance and involves his colleague in an unbureaucratic way has proven to be successful. The figures would make it clear that the treating physicians use the instrument only in justified cases. In the past year, on a quarterly average, they only resorted to an urgent referral all over the country just over 20,000 times. That's about 1.3 percent of all 1.65 million transfers per quarter. This, however, with a continuously rising trend. So far, a doctor in Mecklenburg-Vorpommern issues the urgent referral on average between four and six times a quarter. Doctors and AOK Northeast see in the referral model that they have introduced together in 2011, a working solution for low waiting times at the specialist. As it was said, there are also with other funds such contracts. It is also accepted among the doctors, because it is effective and at the same time low in bureaucracy. The AOK Northeast observed a higher patient satisfaction in connection with the model.

Custom-fit solutions without legislative influence
The model was also praised by the chairman of the board of doctors' association, Axel Rambow: „The concept makes it possible to distinguish between the perceived urgency of treatment from the patient and the actual medical urgency, because a physician always categorizes according to the medical need.“ In really urgent cases, this shortens the waiting time of patients. Declining eyesight, tingling in the limbs or an itchy rash were not trivial complaints. Those affected would need medical help as quickly as possible. Green MP Harald Terpe said „Schwerin People's Daily“, that the model is showing, „Today, tailor-made solutions are tested and implemented on-site without any regulatory influence.“

Criticism of considerations of the black-red government
There are criticisms of the considerations of the black-red federal government to oblige the medical profession to set up service centers, the patients on the phone to arrange an appointment with a specialist. AOK and Kassenärztliche Vereinigung see this skeptically. „This becomes an anonymous mass business“, so Rambow. There is the danger that patients on a hotline only type in numbers in their mobile phone. The Schwerin cardiologist Karsten Bunge said that the personal conversation between doctor and patient should not be omitted. (Sb)